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Drawing INR levels from a central line

We have a number of patients in which it is virtually impossible to peripherally draw their INR level. Is there current research that supports best practice on blood sampling and heparinized lines? I could not find anything in the INS Infusion Nursing, An evidence-based approach book. THanks

Numerous studies

Yes, there are numerous studies showing how intraluminal heparin leads to erroneous coagulation studies.

1.    Hinds P, Quargnenti A, Gattuso J, Srivastava D. Comparing the results of coagulation tests on blood drawn by venipuncture and through heparinized tunneled venous access devices in pediatric patients with cancer. Oncology Nursing Forum. 2002;29(3).
2.    Mayo DJ, Dimond EP, Kramer W, McDonald KH. Discard volumes necessary for clinically useful coagulation studies from heparinized Hickman catheters. Oncology Nursing Forum. 1996;23(4):671-675.

3.    Pinto K. Accuracy of coagulation values obtained fron a heparinized central venous catheter. Oncology Nursing Forum. 1994;21(3):573-575.



Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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